SIGNIFICANCE OF NEUTROPHIL LYMPHOCYTE RATIO AS PREDICTOR OF INHOSPITAL MORTALITY IN ACUTE CORONARY SYNDROME

Beer bhan Singh, S. K. Sridhar, Manoj Indurkar

Abstract


INTRODUCTION: Atherosclerosis is a low-grade inflammatory disease that results in atherosclerotic plaque formation
and progressive stenosis of the coronary arteries. Inflammation plays an important role in all stages of atherosclerosis,
from initiation and growth to complication of plaque including unstable angina pectoris (USAP), non-ST-elevation
myocardial infarction (non-STEMI) and ST-elevation myocardial infarction (STEMI). Increased neutrophil to lymphocyte
ratio (NLR) has been shown to play a role in the pathophysiology of atherosclerotic disease. It has been reported that
increased values of NLR is associated with cardiovascular diseases. In addition, these parameters have been shown to be
a predictor of morbidity and mortality in patients with ACS. However, few reports have investigated so far the
relationship between these parameters and the complexity in patients with ACS, with contrasting results. Therefore, the
aim of the current study is to evaluate the prognostic significance of NLR in patients with ACS.
METHOD: We did an observational study on consecutive 200 patients diagnosed with ACS from January 2018 to June
2019 in our department. On admission day, once the ACS is diagnosed, included patients are investigated for NLR and
their morbidity and mortality upto discharge.
OBSERVATION AND RESULTS: Patients were divided on the basis of pre-treatment, on-admission NLR into ≤2, 2.1-3,
3.1-4, 4.1-5, 5.1-6, 6.1-7, ≥7.1. As NLR value increases, Survival rate is decreasing and mortality rate is increasing with
significant P value of 0.0003.
CONCLUSION: NLR value is a useful, easily calculable, simple tool , available from routine CBC which is done in every
patient regularly in all hospitals and can be used independently of other parameters to risk stratify patients of Acute
coronary syndrome.


Keywords


Acs, Nlr, Inhospital Mortality

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